The nation’s hospitals must demonstrate that they have collected the vital statistics of more than 80 percent of their patients in digital form if they want to continue receiving as much as $14.6 billion in federal grants for installing electronic health records (EHR) technology. Awards as large as $11.5 million are available to hospitals that can prove “meaningful use” of the equipment, under preliminary rules issued by the Obama administration. Physicians can apply for grants of $44,000 or $64,000, depending on whether they treat patients in Medicare or Medicaid.
The rules continue carrying out an initiative in the American Recovery and Reinvestment Act (ARRA) as a step toward overhauling the nation’s healthcare system, specifically in the Health Information Technology for Economic and Clinical Health (HITECH) Act. Hospitals and doctors should achieve “substantial benefits” from adopting digital records, including lower record-keeping costs, fewer pointless tests, shorter hospital stays and reduced medical errors.
The percentage of U.S. hospitals that have adopted electronic records more than doubled between 2009 and 2011, to 35 percent, according to the American Hospital Association. Approximately 85 percent of hospitals told the association that they plan to take advantage of government incentives by 2015. The government expects that by 2019, 96 percent of hospitals will adopt electronic records and at least 36 percent of doctors’ practices.
In this second stage of adoption of EHR, the government is emphasizing making sure that electronic systems can talk to one another – or are “interoperable.” According to Kaiser Health News, it’s “a real push ahead,” said Farzad Mostashari, the national coordinator for health information technology. The rules require systems be able to transfer patient information across platforms. A “summary of care” — including past diagnoses, procedures and test results – must be able to follow patients across referrals and changes in health care provider. Additionally, the information should be available to some patients, who under Stage 2 requirements must be allowed to view their records online, as well as download and transfer information. Finally, some patients must be able to communicate with their doctors through a secure, online system.
According to a survey of 302 hospital IT executives, more than one-quarter said they had already proven to the Centers for Medicare and Medicaid Services (CMS) that they have met the government’s standard for the first stage of meaningful use of health IT. That means they have demonstrated that they have the baseline capabilities in their CMS-approved health IT system to collect and submit data. Stage 2 also deals with security of exchanging patient information electronically, particularly the risk of a doctor mistakenly leaving his laptop or iPad accessible to the public. “A huge, huge, huge portion of all breaches don’t occur because someone hacked into the system; they occur because people left their laptop on the train and they didn’t encrypt it,” Mostashari said.
Writing on the practicefusion.com website, Robert Rowley, M.D., says that “Stage 2 is about connectivity. So let us take a step back and re-assess the larger picture. Stage 1 Meaningful Use is about adoption of EHRs into the daily practice of clinicians and hospitals. It is about moving the documentation of healthcare away from paper, and onto a digital platform. The platform didn’t really have to connect with anything, though the capability to connect needs to be built for the technology to be Certified. Stage 2 is about connectivity. Now that EHRs are adopted, implemented and used meaningfully, the next stage is intended to be about connecting the silos together. Stage 3, to come later, will be about inserting Decision Support between the connections, so that best practices (as well as authorizations) become part of the daily fabric of healthcare.”
A little-known fact is that EHR adoption is having a positive impact on healthcare IT job creation. According to job resource Medzilla, an estimated 50,000 new jobs have been created in the health IT field since 2009, when the government passed the HITECH Act, which authorized funding for the EHR incentive program. “The statistics over the past few months have been more than encouraging,” said Del Johnson, director of client relations at Medzilla. “Here you have two, previously separate industries that are rapidly growing into one another. Where the two meet you have an opportunity to explore a completely new labor pool.”